title: Global mental health: transformative capacity building in Nicaragua.
abstract: BACKGROUND
  Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels.
  
  
  OBJECTIVE
  Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León) and the Centre for Addiction and Mental Health (CAMH) in Canada, which is aimed at improving mental healthcare in Nicaragua.
  
  
  METHODS
  Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified.
  
  
  RESULTS
  A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada.
  
  
  CONCLUSIONS
  To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and implications for global health action are identified and discussed.
authors.affiliation: Office of Transformative Global Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Jaime.Sapag@camh.ca.
authors.forename: Jaime C
authors.initials: JC
authors.lastname: Sapag
authors.forename: Andrés
authors.initials: A
authors.lastname: Herrera
authors.forename: Ruth
authors.initials: R
authors.lastname: Trainor
authors.forename: Trinidad
authors.initials: T
authors.lastname: Caldera
authors.forename: Akwatu
authors.initials: A
authors.lastname: Khenti
mesh_terms: D002170:Canada; D057191:Capacity Building / Q000379:methods / Q000458:organization & administration*; D004493:Education; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007391:International Cooperation; D008603:Mental Health / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000458:organization & administration* / Q000600:supply & distribution; D020380:Needs Assessment; D009527:Nicaragua
keywords: Global mental health; Latin America; Nicaragua; capacity building; primary healthcare